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Abstract

While the influenza vaccine is safe, efficacious, and recommended for everyone over the age of six months, rates of vaccination for seasonal influenza remain sub-optimal. During the 2011-2012 influenza season, only 39% of adults were vaccinated against influenza while the Healthy People 2020 goals aim to achieve vaccination rates of 80-90% (Centers for Disease Control and Prevention 2012; U.S. Department of Health and Human Services 2012). This dissertation consists of three papers which assessed factors associated with influenza vaccination among several populations, including healthcare professionals, adults who have close contact with children, and young and middle-aged adults, using data from focus groups, and the 2009 and 2010 RAND Influenza Vaccine Tracking Surveys. The main findings from the papers are 1) Healthcare professionals with children in the household were more likely to be vaccinated for H1N1 influenza but were no more likely to be vaccinated for seasonal influenza than healthcare professionals without children in the household, 2) Healthcare provider-issued reminders and recommendations for influenza vaccination were positively associated with influenza vaccine uptake among all adults regardless of age, and 3) Childcare workers were concerned that influenza vaccination would make them sick and were distrustful of physicians' advice to be vaccinated for influenza.

Table of Contents

Chapter One

Introduction

Chapter Two

Vaccine Decision Model

Chapter Three

Influenza Vaccination among Healthcare Professionals and Non-Healthcare Professionals: Do Children in the Household Matter?

Chapter Four

Healthcare Provider-Issued Reminders and Recommendations for Influenza Vaccination: Does the Patient's Age Matter?

Chapter Five

Influenza Vaccine Knowledge and Attitudes among Adults who have Close, Daily Contact with Children Outside of the Home

Appendix

Vaccine Model Calculations

Research conducted by

This document was submitted as a dissertation in August 2013 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Jeanne Ringel (Chair), Katherine Harris, and M. Rebecca Kilburn.

This report is part of the RAND Corporation dissertation series. PRGS dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world's leading producer of Ph.D.'s in policy analysis. The dissertations are supervised, reviewed, and approved by a PRGS faculty committee overseeing each dissertation.

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